Reconstructive Conundrums in Dermatologic Surgery

Desiree S Ratner, MD, Director of Dermatologic Surgery at the Columbia University Medical Center, Co-director of the Multidisciplinary Melanoma Center at the Columbia University Medical Center, Clinical Professor of Dermatology at the College of Physicians and Surgeons of Columbia University.

'Best of the Best' solutions to challenging reconstructive surgery of the nose
 
The nose, with its unique and individual topography, presents particular challenges for reconstructive and skin cancer surgeons. A number of approaches can be adopted, but how does the dermatologic surgeon choose the best for any particular defect?
 
Reconstructive Conundrums in Dermatology: The Nose provides an atlas compendium of novel approaches to these challenges. Based on the Reconstructive Conundrum series published in the journal Dermatologic Surgery, a range of cases provide photographs of the defect before and immediately after reconstruction, and two long-term, follow-up images. The authors provide a detailed explanation for their choice of reconstruction. The Editors' commentaries allow residents and experienced surgeons alike to compare different reconstructive alternatives and to explore the thought processes behind them.
 
The 30 conundrums each provide a full background to the problem and the strategies underpinning successful surgical solution. They have been grouped into nasal subunits covering:
* Nasal dorsum
* Nasal sidewall
* Nasal tip
* Nasal ala
* Alar groove
* Alar rim
 
Jam packed with clinical wisdom and surgical pearls, Reconstructive Conundrums in Dermatologic Surgery: The Nose provides a guiding hand to anyone faced with daunting surgical reconstructions.

Introduction
 
Part I Nasal Dorsum
 
1 Combined Linear Closure and Burow's Graft for a Dorsal Nasal Defect
 
2 Reconstruction of Two Nasal Defects Following Mohs Surgery
 
3 Repair of Adjacent Nasal Defects with One Double-Rotation Flap Closure
 
4 Contralateral Nasolabial Flap for a Large Nasal Defect
 
Part II Nasal Sidewall
 
5 Dual Nasal Sidewall and Lip Defects Combined into a Single Arcuate Advancement Flap
 
6 Advancement Flap in the Reconstruction of a Lateral Nasal Sidewall Defect
 
7 Repair of the Left Nasal Sidewall, Nasofacial Sulcus, and Medial Cheek
 
Part III Nasal Tip
 
8 The Dorsal Nasal Flap for Reconstruction of Large Nasal Tip Defects
 
9 Adjunctive Use of Primary Nasal Tip Closure to Facilitate Local Flap Closure of Challenging Nasal Defects
 
10 Repair of a Large, Exposed-Cartilage Nasal Tip Defect Using Nasalis-Based Subcutaneous Pedicle Flaps and Full-Thickness Skin Grafting
 
11 Nasal Tip Wound Repair Using a Rhombic Transposition Flap with a Double Z-Plasty at Its Base
 
Part IV Nasal Ala
 
12 Spiral Subcutaneous Island Pedicle Advancement Flap for Repair of Alar Defects
 
13 Combined Hinge Flap Full-Thickness Skin Graft for a Through-and-Through Nasal Defect
 
14 Combined Hinge and Nasolabial Transposition Flap for Repair of a Full-Thickness Nasal Alar Defect
 
Part V Alar Groove/Perialar Defects
 
15 Shark Island Pedicle Flap for Repair of Combined Nasal Ala-Perialar Defects
 
16 "Jigsaw Puzzle" Advancement Flap for Repair of a Surgical Defect Involving the Lateral Nasal Ala
 
17 Dog-Ear Island Pedicle Flap for Repair of Ala and Nasal Wall Defects
 
Part VI Alar Rim
 
18 Repair of an Alar Defect
 
19 Reconstruction of a Full Thickness Soft Triangle Defect
 
20 A Tunneled and Turned-Over Nasolabial Flap for Reconstruction of Full-Thickness Nasal Ala Defects
 
21 Reconstruction of an Alar Rim Defect
 
22 Island Pedicle Flaps for Repair of a Nose, Cheek, and Lip Defect
 
23 Revisionary Technique for Alar Rim Notching: The Stair-Step Flap
 
24 Reconstruction of a Surgical Defect Involving the Nasal Ala and Alar Crease
 
25 One-Stage Reconstruction of a Full-Thickness Nasal Defect Involving the Alar Rim
 
26 Repair of a Defect on the Ala
 

27 Single-Stage Reconstruction of a Combined Upper Lip and Nasal Ala Defect
 
28 Nasal Dorsum Transposition Flap for Closure of an Alar Rim Defect
 
29 Bilobed Flap for Full-Thickness Nasal Defect: A Common Flap for an Uncommon Indication
 
30 One-Stage Reconstruction Following Complete Alar Loss
 
Index